Dr John W Norris writes: Are we pouring gasoline on one public health crisis hoping to treat another? Voters said no in Key Haven, Florida, to a trial release of genetically modified antibiotic-dependent mosquitoes in 2016. The analysis of FDA public comment by Bloss et al was a start to look at why. One significant factor was the impact of community physicians on the delay of the field trial.

Shortly after the close of the FDA public comment period, practicing physicians in the Key Haven, Florida area petitioned for safety data related to these genetically modified (GM) mosquitoes. They shared their concerns with the community (see Facebook post below).

These GM insects are programmed to require tetracycline as a maturation factor. If they do not receive the antibiotic in sufficient dosage to penetrate every cell and neutralize the implanted lethal gene, the insects die in early larval stage. If they receive a sufficient dosage, they will live and reproduce.

The World Health Organization (WHO) estimates 700,000 people die each year from antibiotic resistant bacterial infections (see here, page 23). More than 30,000 women and 400,000 newborns die each year from infections around the time of birth. Most of these deaths occur in low-income countries, and the situation will only worsen as the antibiotics available for treating infections become less effective, owing to the emergence of antibiotic-resistant bacteria.

Community meetings were held after the FDA comment period where the answer to whether resistant bacteria were present was never disclosed. 14,700,000 GM insects would be released over 22 months on two populated island streets without regard to immunocompetence of inhabitants. Petitioners opposed release without bacterial resistance data on the adult, to-be-released GM insects and that data being factored into any possible release.

Barry Kreiswirth, PhD at PHRI/Rutgers University, offered his lab to genetically characterize resistance among the isolated microbes from the insect. Having a resistance genotype may provide an opportunity to track these changes among human isolates collected from both the test and control areas. In addition, one could also evaluate nasal swabs from volunteers from both test and control areas to observe changes in resistance among carriage strains.

Tracking antibiogram data for resistance changes pre- and post-release also was discussed in the release and non-release areas of the islands (see here and here). Antibiograms are tables that compare resistance percentages for tracked bacteria. The Health Services of the Cayman Islands very likely can produce this data for years before and follow years after the antibiotic-dependent, genetically modified insects initial release.

In 2009 and 2010, our community was sensitized to mosquito-borne illnesses by a Dengue outbreak. We appreciate the proposed benefit of this technology. We question the use of an antibiotic while neglecting that uses bacterial impact. Alexander Fleming called the misuser of antibiotics the “the ignorant man” in his 1945 Nobel Prize speech.

It is the petitioning physician’s opinion this data is required to make a risk benefit analysis of threat from bacterial resistance vs threat of mosquito-borne illnesses in the use of antibiotic-dependent, GM insects.

Comments (36)

Oxitec putting up a good fight here though! LOL! Too bad “anonymous” is alive and well in this country. That’s one character that should be whipped out of town – I so saying even while I use his coverage to say that the aggressive name calling by Oxitec’s cronies doesn’t negate the importance of the antibiotic resistance and the transparency of the doctor to give his full name and not hide behind “Anonymous” Come on! Stop hiding! You all have hid the truth for long enough! Enough of this bull! You remind me of what my grandparents used to say: need to tie you to a pole during dusk bite!

It is very important for everyone to do their part in preventing the growth of the mosquito population. Some may think that the Zika virus does not affect them and may not be worried about prevention. But, it is important to remember that it may affect your neighbor or family member. I spent many hours going door to door and handing out flyers that encourage residents to take the necessary precautions to prevent mosquito growth. Raising awareness is the first step and then people must believe that it is important enough for them to take action. By continually removing standing water around our homes, we can all do our part to help prevent these viruses.

Well in all my 30+ years living in the Cayman Islands I have never seen such large, vicious mosquitos around this place. And the bites they leave behind are huge, and the island is still infested by mosquitos and our mosquito planes and trucks are still having to do their fly/drive-bys… this GMO mosquito project is a waste of resources.

Why didn’t they just finish their trials and tests in Brazil where they started? Oxitec is happy to try their experiment anywhere there is a weak, spineless Government that will allow it.

I have reviewed the contradicting information – at first they said the mosquitos COULD NOT reproduce – then they said the mosquitos would die before reproduction – then they said when the mosquitos DO reproduce the next generation would die before reproduction… that’s just one example.

There is a reason people insist on non-GMO foods – messing with genetics is not smart at all.

There is absolutely nothing that can justify this trial experiment taking place in Cayman. Our country simply does not need it. I Oxitec has trolls out on every platform from Facebook to news outlets to defend this ridiculous project.

The old adage “if you don’t listen you will feel” applies. Or “reap what you sow”. We just have to sit back now and watch the island go to pot with diseases which will have no cure because of the introduction to GM mosquitoes. Pick your poison.. mosquitoes or a disease that is antibiotic resistant.. die from the second, but not from the first, really intelligent reasoning there hence why Cayman was the guinea pig trial contained on an island, unable to spread.

Data let’s people choose wisely. I read about George Town Zika. Risk in an outbreak is much more pressing evidence for a trial. We had no documented transmission of any mosquito borne diseases. Petitioners asked was there a risk to our patients of a release from anything to do with the GM trial. Promotion of antibiotic resistant bacteria (germs) stood out. We petitioned for safety data. The response was less than satisfying. When pressed the FDA bowed out. They still intend to use these GM insects on our islands. That is why I commented to an old post in cayman news service. The news service asked to take it to this level.

I have been impressed by what I have learned of the mosquito control in the Caymans as I am with the healthcare resources.

I completely agree with pick your poison. Data is needed to choose wisely. The sun causes cancer and life. Water you drown or die of thirst. All in balance gives life. I enjoy the sun. I enjoy a cool glass of water. I wrote the petition asking for data as well. Others signed quickly. Risk benefit analysis in Search of balance.

As long as you are referring to data Dr. Norris, how much tetracycline resistance is already in the environment? Tetracycline is a fairly old antibiotic (I recall it being prescribed for acne back in the 1970s). How often do you prescribe tetracycline versus newer antibiotics?

Are mosquitoes known to transmit bacteria through biting? What about Aedes aegypti, which is the only species currently treated with tetracycline? If bacteria are not transmitted by biting, what is your proposed mechanism for spread of tetracycline resistant bacteria? Is there any precedent for that mechanism or is this just coming from your imagination? Anything is possible – but many fewer things are probable.

In terms of motivation, are you compensated by any of the anti-GMO NGOs? They seem to be keeping a fairly low profile since they likely understand that this issue could potentially come back to bite them (pun intended) if diseases break out in part because they’ve thwarted progress on this technology.

As mentioned elsewhere, I’m a retired molecular biologist who has been following this story for over two years. It’s intriguing enough that I purchased some stock in Oxitec’s parent company some time ago (a relatively small amount and not a recommendation as it is high risk).

Pseudoscientific scaremongering. Unanswered questions are not evidence of anything. If the onus was on every scientist to answer every possible question based on the flimsiest concerns, they would spend all their time responding to questions instead of developing new technology.

As a believer in science, you scare me and your statement make no sense. Science is based on questions as much as the answers to those questions. There are protocols, established international protocols mind you, for experimenting – especially on humans. Add the environment with that and you have a potential recipe for disaster. Who are you? Some bruised ego maniac here to prove you are intelligent? Let me guess: one of those back yard scientist cooking up a concoction and saying: trust me it works. Better yet, you are protecting a bruised ego or perhaps trying desperately to cast doubt on or worst imply that those who ask questions are not knowledgeable enough to ask the probing questions. Is that not why you ask questions in the first instance? Try removing your ego. Read concerns of these doctors scientists themselves if you will, in the broader scheme of things) and stop trying to win a war in your head.

bwahaha fake mosquitoes! haha but new technology! ooooohkay then Einstein! You sound as bright as a light bulb. Lights out. Go to sleep, you are obviously trying to be intelligent. You fail! Still laughing. Dismal failure right right folks ROFLMAO

The government has not conducted research on this bacteria topic. It has no conclusive reports on this bacterial concern. It was not aware of it and I have a feeling that the implications laid out in the above article were never strongly considered here.

If GeneWatch is wrong, nothing negates this bacterial concern, because the research on antibiograms has never been conducted.

If GeneWatch is right, it strengthens this concern, because the research on antibiograms has never been conducted.

The impact assessments etc were conducted in a classroom in the orient for the mosquitoes to be released here. That was a really faulty assessment, if I may say so myself.

The government never recruited an independent assessment for the deployment of the mosquitos (MRCU overseeing an MRCU project is not an independent assessment).

Here is a new concern: if the mosquitos increase tetracycline resistance, what does that mean for the children and the aged in particular?

I encourage the country to step away from the Oxitec argument and embark on the research related to bacterial resistance. The first release site was at the clinic in West Bay next to the primary school. If there is bacterial resistance concerns, does this now mean that our children now bear the greatest risk?

Let’s put the Oxitect/non-Oxitec supporter arguments aside and look at what’s the best thing regarding this concern and that best thing is research. I’d like to believe that the bacterial concerns can warrant a research as well, if mosquitos and the spread of disease does. Of course bacterial resistance would make eliminating any mosquito borne illness un-treatable by way of antibiotics in the future. That could be deathly.

This research could lead to greater revelations than just mosquitos. We’ll never know until we try.

Antibiotic resistance does not confer super-immunity, it confers death. If the mosquitos become resistant to Tetracyline, then unfortunately, they die as sick mutated larvae having never achieved emergence to fly around – along with any aspirations the 99% male mosquitos may have had to grow up and one day mate with unsuspecting females. The end.

It’s not the mosquitoes that become resistant to tetracycline, it the bacteria they harbor. Those bacteria are accidental victims of the process. They will be shared by the gm mosquitoes each place they land. NO BITES required. Just like when you shake hands with somebody or touch a table too you share bacteria (germs) with that contact.

So if a male gm mosquito lands on a door knob, we ask what germs is it depositing there for the man woman or child who touched that door knob next? No antibiotics on the door, the bacteria are the question that were resistant enough to survive the bath in the lab

So humans. Flys. But not mosquitoes have bacteria (germs) is your position?

Guess you did not read the WHO references about the death toll to adults and children from resistant bacteria. Nor did you read the GENEWATCH PAPER on why the concern with the way they cooked up these bugs. You may not have noticed how the FDA in the USA has dropped supervision of these bugs as this question and others aren’t answered.

All we wanted was cultures like that done for sore throats or bladder infections. Apply the findings to any release. Where are the cultures of what is being released?

1. Tetracycline gm mosquitoes antidote to their death gene. They don’t have it when they leave the ‘factory’, but the bacteria they have can be expected to be resistant to tetracycline or how would the have survived the bath with the mosquitoes
2. Gene watch was reference that displays the concerns approximately a third of key haven area physicians shared
3. Misusing antibiotics is dangerous.
4. Here is Harvard vid displaying how fast bacterial (germ) resistance developshttps://youtu.be/plVk4NVIUh8
5. insects have germs as pepole do. If you raise bacteria (germs) in a bath of antibiotics with mosquitoes, it’s easy to question whether antioxidants resistant bacteria are all over the gm mosquitoes. We question it? Perhaps data from the Cayman Health Services can answer the question

And yours? I was asking for a doctor, hopefully still a scientist, to provide scientifically valid references. By his own words, two thirds of area physicians have not signed the petition, and having read some of the comments on the petition website, some of those that signed, did so reluctantly or with reservations, Cicadas?

1. Brazil group using the GM mosquito seemed valid with a full video of the process. They were just showing clean equipment, that was not the case in the mosquito factory pictures from the Caymans. Those pictures were taken as the reality of production.
2. Harvard showing the rapidity of mutation would have passed as science to most people
3. Caymans sources on the burden of antibiotic resistance seemed scientific like the other two
4. The way the petition signers was worded above was unclear I agree. Nearly all the physicians who saw the petition signed. It was all done informally and at one hospital meeting. A large percentage of physicians don’t have privileges at the hospital, so they only could hear about the petition in the newspaper and on the radio.
5. As far as reluctant signers or any reservations, the website you viewed was mine. None of them would be expected to post on my Office website. Again the recipe pouring gas on a different health threat was in question. Nobody expected we needed every signature. It was a statement of scientifically based concern. It is some feat to find any petitioner reluctant or having reservations therefore.

Finally, the people voted it down in the trial area. The people said ‘no’.